Effects of shortened hospital stay on perioperative nursing care for patients undergoing surgery

分析2006年601例当天手术（住院时间最短）患者的症状和自报措施，以及2006年术后自我护理相关信息知晓情况调查结果。结果显示，只有不到30%的患者经历了相对严重的疼痛，但他们没有积极寻求帮助，并持“观望”态度。约10%的患者认为他们没有关于术后恢复或生活方式的必要信息，这与总体评估、恢复天数和症状发作显著相关。为了支持病人的自我护理，提供必要的信息和控制他们的症状是很重要的。2007年，为了确定护理的现状和病人的恢复，由于缩短住院时间在普通病房，接受手术后的胃癌患者出院进行了采访。一 ...更多信息 同时，对745个300张床位以上的胃肠外科门诊和病房的护理管理人员进行调查，以了解缩短住院时间对护理工作的影响，并提出解决办法。门诊应答率为42.4%（n=316），病房应答率为38.9%（n=290）。术前住院时间0 ~ 4 d，术后平均住院时间10 ~ 14 d，平均住院时间16.16±4.3 d。缩短住院时间有利于提高经济效益、帮助病人自立、规范护理。但住院时间缩短增加了护士的工作量，加剧了术后患者的焦虑，并凸显了患者自我护理的缺乏和家庭负担的加重，结果存在地区差异。胃癌手术患者表示担心进食和体力下降，术后恢复和住院时间存在个体差异。本次调查结果显示，日本的住院时间越来越短，从护士的角度来看，缩短住院时间增加了工作量，因为患者流动率增加，这使得他们很难建立关系和支持病人的自我护理。为了解决这些问题，已经进行了各种尝试，以改善医院内和社区合作，使用临床路径，并制定患者教育计划。本研究收集了具体的数据，可用于制定高质量的围手术期护理，可以在短时间内在临床环境中实施。少

In 2006, the symptoms and self-reported measures of 601 patients who underwent same-day surgery (the shortest hospital stay) and the results of the 2006 survey on the awareness of information related to postoperative self-care were analyzed. The results showed that just under 30% of patients experienced relatively severe pain, but they did not actively seek help and had a "wait-and-see" attitude. About 10% of the patients felt that they did not have the necessary information about postoperative recovery or lifestyle, and this showed a significant correlation with the overall assessment, the number of days to recovery, and the onset of symptoms. In order to support patient self-care, it is important to provide the necessary information and control their symptoms.In 2007, In order to ascertain the current state of nursing care and patient recovery due to shortened hospital stay in general wards, patients who were discharged after undergoing surgery for gastric cancer were interviewed. A … More survey was also conducted of nursing managers of gastrointestinal surgery outpatient clinics and wards at 745 centers with at least 300 beds to determine the effects of shortened hospital stay on nursing and develop solutions. The rate of response was 42.4% (n=316) for outpatient clinics and 38.9% (n=290) for wards. The length of preoperative hospital stay ranged from 0 to 4 days, and the average length of postoperative hospital stay was mostly in the range from 10 to 14 days and average length of hospital stay was 16.16±4.3. Shortened hospital stay is advantageous for improving economic efficiency, assisting patient independence, and standardizing nursing care. However, shortened hospital stay has increased the workload of nurses and exacerbated postoperative patient anxiety, and highlights the lack of self-care and increased burden on families; there were regional differences in the results. Patients who underwent surgery for gastric cancer stated that they were worried about eating and reduced physical strength, and there were individual differences in postoperative recovery and the length of hospital stay.The results of the present survey showed that, in Japan, the length of hospital stay is getting shorter, and from the viewpoint of nurses, shortened hospital stay has increased their workload because of a higher patient turnover rate, and it has made it difficult for them to form relationships and support patient self-care. To address these issues, various attempts have been made to improve intra-hospital and community collaboration, use clinical paths, and develop patient education programs. The present study gathered concrete data that can be used to develop high-quality perioperative nursing that can be implemented in a short period of time in clinical settings. Less